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Nodular Fasciitis

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Topic updated on 11/10/12 1:45pm
  
Introduction
  • A common reactive lesion that usually occurs in upper extremities of young people (ages 15-35)
    • half of the cases occur in the upper extremities
Presentation
  • Symptoms
    • may be painless or painful
    • often rapidly enlarging mass
Imaging
  • Radiograph are usually normal
  • MRI shows deep seated inhomogeneous mass 
Histology
  • Classic characteristics are
    • short irregular bundles and fascicles 
    • dense reticulum network
    • small amounts of mature collagen
Treatment
  • Operative
    • marginal resection
Differentials & Groups
         
Treated with marginal excison (2)
  
Nodular fasciitis (soft tissue)        
•
  
Periosteal chondroma        
•
  
Neurilemoma (soft tissue)        
•
  
Epidermal inclusion cyst        
•
  
Glomus tumor        
•
  
 
Ibank
  Location
Xray
Xray
CT
B. Scan
MRI
MRI
Histo(1)

Case A

 tibia
 
 
(1) - histology does not always correspond to case 
References
  1. Review of Orthopaedics, 4th Edition, Mark D. Miller, W B Saunders Co, March 2004 
  2. Orthopaedic Knowledge Update 8: Home study syllabus, Edited by Alexander R. Vaccaro, MD 
  3. Miller Colorado Review Lecture Series , Mark D. Miller, Stryker, 2005 
  4. Handbook of Fractures, Joseph D. Zuckerman, Kenneth J. Koval 
  5. Surgical Exposures in Orthopaedics: The Anatomic Approach, Stanley Hoppenfeld, Piet DeBoer
  6. Netter's Concise Atlas of Orthopaedic Anatomy, Frank H. Netter, John A. Craig, Frank H. Netter, John A. Craig, ICOH
  7. Physical Examination of the Spine & Extremities. Stanley Hoppenfeld.Prentice Hall. Copyright 1976

 

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